Overweight women are at greatest risk of retaining weight gained during pregnancy. Postpartum weight retention further exacerbates these women's lifetime risk of obesity and related morbidities. The postpartum period may be a special """"""""teachable moment"""""""" for promoting weight loss. Postpartum changes in weight-related affect, risk perceptions, and self esteem may increase women's receptivity to and success with weight loss. However, in the absence of formalized interventions, postpartum changes in these factors could also undermine weight loss (e.g., added demands of child care may hinder physical activity and proper meal planning). Thus interventions are needed that leverage naturally occurring postpartum weight changes to encourage increased physical activity and adoption of a healthy diet, to accelerate and/or increase postpartum weight loss among women at-risk for lifetime obesity. Moreover, the extent to which postpartum is a teachable moment that may modify the efficacy of formal intervention should be investigated empirically. To this end, proposed is a two-arm, five-year randomized intervention trial. Primiparous women, overweight or obese prior to pregnancy, who delivered healthy infants at a Duke clinic, are the target population. 400 women will be recruited, stratified by racial group (white/other and African American), and randomized to: MINIMAL CARE: a 12-month subscription to a new mothers health magazine, or the ACTIVE MOTHERS POSTPARTUM (AMP) INTERVENTION: the magazine subscription, 10 ACTIVMOMS physical activity sessions, 8 Mom's Time Out nutritional sessions, a sport stroller, and 6 telephone counseling calls. Primary aims are to evaluate whether AMP can: 1: promote greater weight loss 12-months post-intervention (p.i.). 2: increase physical activity at 1 month p.i. 3: lower calorie intake overall, and from fat, at 1-month p.i. The secondary aim is to assess whether participation in the intervention and weight loss is greatest among women for whom the transition to postpartum is a """"""""teachable moment."""""""" Women will be identified and screened for eligibility by chart review and telephone at 32-36 weeks of pregnancy. Participants will be surveyed at 8 weeks postpartum (pre-intervention baseline) and at 1, 6 and 12 months p.i., If effective, the AMP intervention can be disseminated in health and community centers common in both rural and urban communities. In addition, extended follow-up will enable evaluation of long-term benefits of the intervention for weight loss and maintenance.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK064986-02
Application #
6788835
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Kuczmarski, Robert J
Project Start
2003-08-15
Project End
2008-06-30
Budget Start
2004-07-01
Budget End
2005-06-30
Support Year
2
Fiscal Year
2004
Total Cost
$466,503
Indirect Cost
Name
Duke University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
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Lee, Chien-Ti; Stroo, Marissa; Fuemmeler, Bernard et al. (2014) Trajectories of depressive symptoms over 2 years postpartum among overweight or obese women. Womens Health Issues 24:559-66
Fuemmeler, Bernard F; Lovelady, Cheryl A; Zucker, Nancy L et al. (2013) Parental obesity moderates the relationship between childhood appetitive traits and weight. Obesity (Silver Spring) 21:815-23
Pollak, Kathryn I; Coffman, Cynthia J; Alexander, Stewart C et al. (2012) Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity? Fam Pract 29:553-60
Østbye, Truls; Peterson, Bercedis L; Krause, Katrina M et al. (2012) Predictors of postpartum weight change among overweight and obese women: results from the Active Mothers Postpartum study. J Womens Health (Larchmt) 21:215-22
Boothe, Allison S; Brouwer, Rebecca J N; Carter-Edwards, Lori et al. (2011) Unmet social support for healthy behaviors among overweight and obese postpartum women: results from the Active Mothers Postpartum Study. J Womens Health (Larchmt) 20:1677-85
Pollak, Kathryn I; Alexander, Stewart C; Tulsky, James A et al. (2011) Physician empathy and listening: associations with patient satisfaction and autonomy. J Am Board Fam Med 24:665-72
Krause, Katrina M; Lovelady, Cheryl A; Østbye, Truls (2011) Predictors of breastfeeding in overweight and obese women: data from Active Mothers Postpartum (AMP). Matern Child Health J 15:367-75
Pollak, Kathryn I; Coffman, Cynthia J; Alexander, Stewart C et al. (2011) Predictors of weight loss communication in primary care encounters. Patient Educ Couns 85:e175-82

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